﻿<%@ Page Title="" Language="C#" MasterPageFile="~/Views/Shared/Site.Master" Inherits="System.Web.Mvc.ViewPage<dynamic>" %>

<asp:Content ID="Content1" ContentPlaceHolderID="TitleContent" runat="server">
	Rendir
    <script language="javascript" type="text/javascript">
// <![CDATA[

        function textfield9_onclick() {

        }

        function button_onclick() {

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// ]]>
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</asp:Content>

<asp:Content ID="Content2" ContentPlaceHolderID="MainContent" runat="server">

    <form id="form1" runat="server">

    <h2>Registrar Afiliado a la Póliza Seguro</h2>
    <p><table width="200" border="1">
  <tr>
    <td>Codigo</td>
    <td><label>
      <input type="text" name="textfield" id="textfield" />
    </label></td>
    <td>Nombres</td>
    <td><input type="text" name="textfield4" id="textfield4" /></td>
    <td>Apellidos</td>
    <td><input type="text" name="textfield7" id="textfield7" /></td>
  </tr>
  <tr>
    <td>Area</td>
    <td><input type="text" name="textfield2" id="textfield2" /></td>
    <td>Centro de<br />
        Costo</td>
    <td><input type="text" name="textfield5" id="textfield5" /></td>
    <td># Póliza generado (seguro)</td>
    <td><input type="text" name="textfield8" id="textfield8" /></td>
  </tr>
  <tr>
    <td>Fecha</td>
    <td><input type="text" name="textfield3" id="textfield3" /></td>
    <td class="error"><strong>Codigo Autogenerado</strong></td>
    <td><input type="text" name="textfield6" id="textfield6" /></td>
    <td>&nbsp;</td>
    <td><input type="text" name="textfield9" id="textfield9" onclick="return textfield9_onclick()" /></td>
  </tr>
</table>
<table width="200" border="1">
  <tr>
    <td><label>
      <input type="submit" name="button" id="button" value="Registrar Afiliado" onclick="return button_onclick()" />
    </label></td>
    <td>&nbsp;</td>
  </tr>
</table></p>

    </form>

</asp:Content>
